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Related Concept Videos

General Anesthesia: Overview01:24

General Anesthesia: Overview

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Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Stages of General Anesthesia01:22

Stages of General Anesthesia

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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
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Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

643
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
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Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

887
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
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Recording Brain Electromagnetic Activity During the Administration of the Gaseous Anesthetic Agents Xenon and Nitrous Oxide in Healthy Volunteers
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Anesthesia for Neurosurgical Emergencies.

Shilpa Rao1, Rafi Avitsian2

  • 1Department of Anesthesiology, Yale School of Medicine and Yale New Haven Hospital, 333 Cedar Street, TMP 3, PO Box 208051, New Haven, CT 06520-8051, USA.

Anesthesiology Clinics
|February 4, 2020
PubMed
Summary

Anesthesiologists manage critical neurosurgical emergencies, focusing on maintaining brain and spinal cord perfusion. Prompt intervention for conditions like increased intracranial pressure and altered mental status is key for neuronal recovery.

Keywords:
Cerebral perfusion pressureIntracranial pressureSeizure managementTrauma to spine

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Area of Science:

  • Neurosurgery
  • Anesthesiology
  • Emergency Medicine

Background:

  • Neurosurgical procedures require vigilant monitoring, with neurologic examination and mental status being paramount.
  • Anesthesiologists are integral to managing emergent neurosurgical conditions.
  • Maintaining perfusion pressure is crucial for preventing neuronal damage.

Purpose of the Study:

  • To outline essential management strategies for neurosurgical emergencies.
  • To highlight the anesthesiologist's role in optimizing patient outcomes.
  • To emphasize the importance of continuous perfusion pressure maintenance.

Main Methods:

  • Review of critical neurosurgical emergencies and their anesthetic management.
  • Discussion of strategies for increased intracranial pressure and brain herniation.
  • Guidance on managing altered mental status, status epilepticus, and cervical spine trauma.

Main Results:

  • Effective management hinges on preserving cerebral and spinal cord perfusion.
  • Timely interventions can mitigate neurological deficits.
  • Anesthesiologist's role is critical in stabilizing patients during emergencies.

Conclusions:

  • Maintaining adequate cerebral and spinal cord perfusion pressure is vital for neuronal salvage.
  • Comprehensive anesthetic management is essential for successful neurosurgical emergency care.
  • Proactive strategies are necessary to prevent irreversible neurological damage.